Spontaneous midbrain hemorrhage: Report of seven new cases

Michael J. Link, J. D. Bartleson, Glenn Forbes, Fredric B. Meyer

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Spontaneous midbrain hemorrhage is a unique brain-stem vascular lesion. Sixty-six cases have been reported in the literature, to which we add seven. Of the total of 73 patients reviewed, most presented acutely (66%), but subacute (22%) and chronic onsets (12%) also occurred. Neuro-ophthalmologic abnormalities were found in 88% of patients. Some alteration of consciousness and headache occurred in most patients. Hemiparesis, hemisensory loss, and ataxia were less frequent manifestations. Vascular malformations were suspected or proved in 37% of patients, hypertension was present in 21%, and a bleeding diathesis was noted in 5%. No underlying cause was apparent in 37%. Most patients improved with supportive care only. At follow-up, 23% of patients had no neurologic deficits. In 51% of patients, minor neurologic deficits persisted, related chiefly to cranial nerves III and IV. Moderate deficits persisted in 16% of patients, and 5% of patients died.

Original languageEnglish (US)
Pages (from-to)58-65
Number of pages8
JournalSurgical Neurology
Volume39
Issue number1
DOIs
StatePublished - Jan 1993

Keywords

  • Arteriovenous malformation
  • Hemorrhage
  • Midbrain
  • Upgaze paresis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Link, M. J., Bartleson, J. D., Forbes, G., & Meyer, F. B. (1993). Spontaneous midbrain hemorrhage: Report of seven new cases. Surgical Neurology, 39(1), 58-65. https://doi.org/10.1016/0090-3019(93)90112-E